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121 Camp St #112 Building Permits
i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 TOWN OF YARM UTH OCT 3 12 (PLEASE PRINT IN INK OA PI ALL -INFO ATION) To the Inspector of Wires: By this applice work described below. Location (Street ber Owner or Tenant ` v Owner's Address l (OFFICE SE ONLY) By Fee: $ PERMIT •—r)L-, Date: gives notice of his or her intention to perform the electrical Is this permit in conj Mlya--Uis- with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building r Utility Authorization No. Existing Service Amps / Volts OverheadQ New Service Amps /, 9`k glts Overhead Number of Feeders and Location and Nature of Proposed electrical Work: N Undgrd C] No. of Meters Undgrd Q�No. of Meters rmm.lotinn of tho fnllnwino table may he waived by the Insnector of Wires No. of Total No. of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans Transformers KVA No. of Lijzhtiniz Outlets No. of Hot Tubs Generators KVA Above n- ❑ � No. of Emergency Lighting No. of Lighting Fixtures SwimmingPool md. md. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones o. of Detection an No. of Switches No. of Gas Burners Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices Heat Pump Num er — Tons — — KW — No. of Self -Contained No. of Waste Disposers Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Other Local Connection No. of Dryers Heating Appliances KW Secutity Systems: No. of Devtces or Equip valent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or uivalent rva-.__ Arracn aaamonai aeratt y aeatreu, ur ua rerfuucu uy the uuvcuu. uj ..• ei. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to permit issuing office. CHECK ONE: INSURANCE;. BOND C OTHER (Specify:) Estimated Value of Work to Start: MD� IMI� Inspbctions to be I certify, unde the i s and p s o jary, NAM - i� ensee: V�1. If applicabl "exett� ' i the licen er Address OWNER'S INSURANCE WAIVER: I am aware that the Li below, I hereby waive this requirement. I am the (check o Owner/Agent (Expuauon Date) (When required by municipal policy.) in cccodance with MEC Rule 10, and upon completion. gtt to on this application is true and complete LIC. NO. LIC. NO. ,\\ Bus. Tel. No.: 11v Alt. Tel. No.: not have the liability insurance coverage normally required by law. By my signature owner's agent. 0 Telephone Signature [Rev. 04/001 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 OF yq = TOWN OF YARMOUTH wn�EESE NOV 0 3 20 ., (PLEASE PRINT IN INK OR! TYPE ALL INFORMATION) (OFFICE USE ONLY) Fee: $ lz✓`a PERMIT NO. To the Inspector of Wires: By this application the undersned gives notice of his or her i work described below. 67 U n C Location (Street & Owner or /� % eter, if e o'1) /rP. yt°ine ��A ention to perform the electrical � 1/2— No. ? 7 0 — (eve% Is this permit in conjunction with a building permit? 2rYes Q No (Check Appropriate Box)) Purpose of Building Utility Authorization No. ��70 3 73 Existing Service Amps / Volts Overhead Undgrd C] No. of Meters New Service LGL Amps t-;29/> //::�D Volts Overhead Undgrd F3 No. of Meters Number of Feeders and Location and Nature of Proposed electrical Work:_ No. of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures A ove n- SwimmingPool Emil. md. � No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. oDetection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Num er — — Tons — — K K — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local Connection Other No. of Dryers rY Heating Appliances KW g PP Security Systems: No. of Devices or Equilivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H: dromassa a Bathtubs Y g No. of Motors Total HP Telecommunications Wiring No. of Devices or uivalent IIAttach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to th permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER[] (Specify:) 2 c/ IZ r c(� (Expiration Date) �stimated Value of Electrical Work: 6 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pai . d p alties off pe 'ury, that the information on this application is true and complete. � i>iRM NAME: i LIC. NO. 3:0 ? -::� _�') (If applicable, enter "exempt" in the license number line.) LIC. NO. Bus. TeI. No.: _5-d9 `(�$ o h 96 J Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) owner owner's agent. ❑ Owner/Agent Signature Telephone [Rev. 04/00] WPS - Permit • Work Order Information PJS TAR WPS - Permit Page 1 of 1 Utility AUth/WO M 01483573 Date: 11/032005 Company ALICE DESAULNIERS Rep: Report By: YAR 121 CAMP ST-UNIiri.i2`VILCAGES AT CAMP ST /P026 Status: PLAN Service: NEW Type: RES Nature of Work: NEW 100 AMPS SERVICE... UNDERGROUND TO HH TO TRANS #026... NEW DEV... 1600 SQ FT ... GAS HEAT, HW...ELECTRIC STOVE AND DRYER..NO AC ... PENDING INSPECTION Service Information: There is no Service Information. Permit Information Permit #: E06410 Meters: 1 Reseal (YIN): Y Date: 12/14/2005 Inspector: W10060 Description: •P Search List 7--de—tail Contacts Is NSTARHomeWPS Loaon WPS Help Comments VVO Request WPS News lRJ POP r• O� Copyright 2003 NSTAR, 800 Boylston Street, Boston MA USA. All rights reserved. Reproduction In whole or In part of any graphics, images, text or other content at this web site must be granted by NSTAR, Boston, MA, USA. Unauthorized modification of any information stored at this site may result in criminal prosecution. http://www.nstaronline,comlappstwpslwpspennit.cfm?Page=Permit&Unique= f ts_'2005-,,. 12/14/2005 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (OFFICE USE ONLY) TOWN OF YARMOUTH By Fee: $ i2S 0 PERMIT NO. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: - To the Inspector of Wires: By this application the undersi ned gives notice of his or her i work described below. n Location (Street & NumbedI> e` `� Owner or Owner's le ; ) ention to perform the electrical � No. 7 / ,? — %,� i Is this permit in conjunction with a building permit? ErYes C3 No (Check Appropriate Box) Purpose of Building ��-�'� �� Utility Authorization No. �70 3 73 Existing Service Amps / Volts OverheadQ Undgrd NO. of Meters New Service GL Amps o `✓D /APO Volts Overhead❑ Undgrd 0__ No. of Meters Number of Feeders and Location and ature of roposed electrical No. of Total 'vo. of Recesse'x No of eil: us . Paddle Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA A ve n- No. o Emergency Lighting No. of LightingFixtures Swimmin Pool rnd. rod. Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches - No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices Heat mp um r ons No. of Self -Contained No. of Waste Disposers Totals: — — — — Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local Connection ❑ Other No, of Dryers rY Heating Appliances KW g PP Secutity Systems: No. of Devices or ui valent No. of Water No. of No. of Data Wiring: Heaters KW Signs Ballasts No. of Devices or Equivalent No. H dromassa a Bathtubs No. of Motors Total HP Telecommunications Wiring: y g No. of Devices or uivalent I Attach additional derail rf desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no pennit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of URANCE 97 same to th permit issuing office. 1 CHECK ONE: INSBOND[3 OTHERQ c/ r (Specify:) 2 , cl T (Expiration Date) Estimated Value of Electrical Work: Ud (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pai d alties o pe 'ury, that the information on this application is true and completer -=ZFMjCNAME: LIC. NO. �u,lee: Signature �_ LIC. NO. (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 5e9 ` ':I o IS 96 S Address- Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) owner ❑ owner's agent. Q Owner/Agent Signature Telephone No. i • CJ o • CJ Co .w..W mmonwealth of Massachusetts Official Use Only Department of Fire Services PermitNo-Ob— 3CJOccupancy and Fee Checked ,�} '� BOARD OF FIRE PREVENTION REGULATIONS .11199j(leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wakto be pafamed in neat&= with the MmuhusM Eectrical Code O&C), 527 CUR 12.00 _ (PLMSEPRINTINWKORTYPEALL INFORMATIOl0 Date: City or Town of: YAFd4= To the Inspector of Wires application�the undersigned gives notice of his or her intention to perform the electrical work described below. n (Street & Number) MILL POND vILLAGE, 121 C=ip St Bldg # /./ Z, Is rorTenant Gatewood Homes/ Jeff Sollows Telephone No. 508-778966 9 r'sAddress .1600 Falmouth Rd., suite 25, Centerville, Ma. 0263.2 permit in conjunction with a building permit? Yes X❑ No ❑ (Check Appropriate Box) seofBuilding_ single family residence Utility Authorization No. m g Service Amps / Volts Overhead El Undgrd ❑ Na of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Woric Fire Alarm System (law voltage control panel) with backilp battery. centrally monitored. Camaletfoi of the fallowine table may be iaamed *v the Inmectnr ofWhr-T Na of Recessed Fixtures No. of Cetl-Snsp. (Paddle) Fans Transformers KVA Na of Lighting Outlets No. of Hot Tubs Generators KVA No. of Iighting Fixtures Swimming Pool 40dVe O d. Battery Uniits g Na of Receptacle Outlets No. of Oil Burners FIRE.AT •ARMS No. of Zones —1—' Na of Switches No. of Gas Burners • o. Of etection.an 7 iaitiatin Devices Na of Ranges Na of Air Coact. Total ns No. of Alerting Devices No. of Waste Disposers p Totals: um er ors o. o ontame Detection/Alerting Devices 7 No. of Dishwashers Space(Area Heating KW Local 0 Corn is ®Other No. of Dryers .. Heating Appliances KW ecunty stems: No. o evices orE ivalent No. of Water KW Heaters o. o o. o Signs Ballasts Data Wiring. No. of Devices or F trivalent Na Hydrumassage Bathtubs No. of Motors Total HP TaRommunications Wiring, No. of Devices or Equivalent O1Mr,k: of MY= INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work � issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited prof of same to the permit issuing office. CEIECK ONE: INSURANCE ® BOND ❑ OnMR ❑ (Specify.) E upuation to Estimated Value of Mecnical Work $750. 00 (When required by municipal policy.) Work to Stan: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: Baltic Security, IncLIh NO.: 1178C Licensee: Jonas R Bielkevicius Signature —' LIC. NO.: 499D (Ifappliaabk, enter "exempt "in the Umuenumkt .lure 02563 Bus. Tel. No.- 508-833-0996 Address: PO Box ,y 609 Sandwic t Alt. Tel No. 508` 77�-3347 OWNER'S INSURANCE WAIVER Jam aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. OwnedAgent Signature. Telephone No. PERMITFEE: $ 40.00 r� APPLICATION FOR PERMIT TO DO GASFITTING r (OFFICE USE ONLY) TOWN OF YARMOUTH i By._._a_ __V___,._—_._.----------------• Fee: $ -- -_L.�- -._... - - --- G_ � - ' Building //�� -ram Owner's AT: Location Type of Occupancy�,;%f New LY Renovation O Replacement ❑ T- - Plans Submitted Yes No Elk W O us i O W W <> z Z W m W! 2 9 R W N W to y 2< S Q 4 O O Y y S c9 ►- W> Z F- W 2 W 4 > 6 tppi W ppJ H W Z . < ¢ S O E C9 r j 4. 2 O < >< d}- G O < J V 0 tL > O a; F- F- O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 7RD FLOOR (PRiN7 OR TYPE1 Check One: Installing Company Name -!LTAtT�'.._ Corp. V Address - �_ .. _ _ G.. 13 _ ...- �?- _----- — .-�- ;.7 Partnership -- `z` --- i4y,,oLA1 !l.S-_...irm/Company.....------DEC.1.4 2005- Business Telephone - --L. -Z ----- aUIL�1 (&-pT. Name of Licensed Plumber or4,Bah!!er _.... ... _. a_. �.. _. �.•_. By -- INSURANCE COVERAGE: Check One I have a current lability insurance policy or its substantial equivalent, Yes £O"No ❑ If you have checked yes, please inocate t e type of coverage by checking the approprtare box. A liability insurance policy Other type of indemnity El Bond ❑ OWNERS INSURANCE WAIVER: 1 am aware tnat the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: — ........... --- .•,_..... ---- ------.�_.. — -... Owner ❑ Agent 0 Signature of Owner or Owner's Agent t hereby certify that all of the details and information I have submitted Signature o Licensed (or entered) in above application are true and accurate to the best of Plumber or Gastitter my knowledge and that all plumbing work and installations performed � S under Permit Issued for this application will be in compliance with all --_- pertinent provisions of the Massachusetts State Plumbing Code and License Number �. .. _ rvoa a rr•erucc. V "(Zit 0-� CZ off li- TOWN OF YARMOUTH APPLICATION FOR PERMIT TO DO PLUMBING �� (OFFICE USE ONLY) By �- aria Fee: $ /09, b/ ) PERMIT NO. r-U( _ Date Owner's AT: Location n;�&'M P ` , Name_ Type of Occupancy New Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ P fZ OS I ��t C F; V. _ ��a£C'm 1`' •�`-\ W .o 01 a Y y W F Y W E O Q J 0 m a= m J 0= a- W N M N Q N 0 W W N y 0 a a } m Q J Z Z V _ a a y Y Z Q ~ W H Q o 2 w y W Q tr N Y 2 N o 0 Z 0 a, o U. W a g a C9 U) J a 7 a H Z D O U. t� Z a 0 Z a a. 0 Q t7 z a 0. ot a to 2 0 a' > a OLL a m y LU X a' O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Address Business Telephone Check One: ❑ Corp. _ ❑ Pa —t, Name of Licensed Plumber OCT 1 1 2005 IJ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes - T No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check on Owner Jg Agent ❑ of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted Signature of ens6d (or entered) in above application are true and accurate to the best of Plu er my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Laws. License Number L� Chapter 142 of the General Type: Master 0 Journeyman I CERTIFY THAT THE FOUNDATION IS LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD AREA / �� . DATE REGISTERED PRO ESSIONAL . LAND SURVEYOR I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE 408 SPECIAL PERMIT. INATE REGISTERED PROFESSIONAL LAND SURVEYOR JON e 1¢0, FOUNDATION LOT 113 I h ti N 19 o. N �N CIV. 1 .N I 2 ^ LOT 110 �.LOT 112 j 1 �7 I AG n 2 8 2005 /Lll l y L l; �J NOTICE • 72•50 Unless and until such time as the original (red) stomp of the 1.A7 10 YJ responsible Professional Engineer, or Professional Land Surveyor S$ appears on this plan: (A) no person or persons, including any municipal or other public officials, may rely upon the Information contained herein: and (8) this plan remains the property of Holmes do McGrath, Inc. AS —BUILT PLAN holmes and mcgrath, inc. OF LOT 112 civil engineers and land surveyors OF PREPARED FOR o MICFIAEL y MILL POND VILLAGE 362 gifford street IN falmouth, ma. 02540 MINtXiw1TH YARMOUTH, MA ,JOB No: 201197 DRAWN: LMC SCALE: 1"=20' DATE: B-25-05 DWG. NO.: A2536A CHECKEDL/4 L < IAN� s TOWN OF YARMOUTH Building Department (508) 398-2231 ext.261 PERMIT NO 6-05-1554_ ISSUE DATE ; _ 6/30/2005 _ ; PROPOSED USE ; APPLICANT _Frank Capra _ _ _ _ _ BUILDING PERMIT JOB WEATHER CARD PERMIT TO ;NewConstruction ; AT (LOCATION) 100121CAMP ST Unit 112 ONING DISTRIC R-25 Bldg. Type: Residential I SUBDIVISION MAP LOT BLOCK 044.21.1.C112 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE CONTRACTOR new construction: 2 baths, 3 bedrooms, 1 diningroom/family room, 1 fireplace, 1 one bay LICENSE 012430 REMARKS garage, 1 livingroom as per plans dated 06/02/05. Subject to compaction & proctor tests. Capra, Frank 1600 Falmouth Road #25 AREA (SO FT) EST COST ($ 1$123,000.00 PERMI r vtE (1i) lzlTtii r.uu I Centerville MA 02632 OWNER iVillage 0 Camp St., LLC 71 UILDING DEPT BY 5087789669 ADDRESS 11600 Falmouth Rd # 25 Centerville Mk 02632 Certificate Issue Date '2 o h r"CERTIFICATE of OCCUPANCY j Departmental'Approval for Certificate of Occupancy and Compliance b.........�w. not& ParmiA Nurnher Aooroved By Remarks E°a1 �W►r C'/1,1- e To be filled In by each division indicated hereon upon completion of its final Inspection. r. TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 �- PERMIT NO B-05-1554_ PERMIT ISSUE DATE ; _ - - - - 00 - - PROPOSED USE _ _ _ _ _ _ - ------ --""' JOB WEATHER CARD APPLICANT Frank Capra PERMIT TO ' New Construction ; AT (LOCATION) 100121CAMP ST Unit 112 r NI ISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C112 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R 4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 diningroom/family room, 1 fireplace, 1 one bay 1EMARKS garage, 1 livingroom as per plans dated 06✓02105. Subject to compaction & proctor tests. REA (SO FT) EST COST ($ $123,000.00 PERMIT FEE ($) $617.00 OWNER IVillage ® Camp St., LLC BUILDING DEPT BY ADDRESS 1600 Falmouth Rd # 25 Centerville MA 102632 INSPECTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 t FIELD COPY .:Note Progress MO r P i i e�lae ��� . or LUC tibb�tts En.01Mering coup, CONSULTING CIVIL ENGINEERS & LAND SURVEYORS ' TECHIIP►C7AIIPC R. D Y R �,.�PQRT OF f_'ONCTRu[TIf] MMC Yarmouth,Mill Pond e, DAM 9/7/05 JOB NO-: 10930.010 Cratrrwood Homes C CTO_R: Homes and. McGrath FIELD TIME: EQUIPMENT WORT M: I Mini -Excavator TRAVEL TDIIE } 6.5 Hours 1 Vibratory Plate Cmpactor NXN MgAkM: Rick H. of Gatewood Homes M9 PEMRMgD: In accordance with a request from the client, I arrived at the refxenced job site at apx 8:00AM for scheduled compaction testing. Upon my arrival I met with Rick of Gmewood Homes who informed , me that compaction testing would be needed at the base of the footings on lots 112, 133, and 134. He informed me that he would get an excavator and dig two test pits on lots 133 and 134 on the outside of the building at footing depth. Rick requested that two compaction tests at footing base be performed on each lot. A total of six compaction tests were taken today. All tests taken did meet, or.e:ceed 959/a compaction. See attached report for detailed information on test locations and results. After testing was completed I informed Rick of all test results, packed up my equipment and left the job site. P. FMndes Lab Technicise 716 County ,-Ste-t, Taunton, MA 02780 Tel. (506) 822-693A Fax (508) 880-7811 E-Mail: hr@tbbeftengineerin9-=n1 r1.M1 k HV.••• .. ., ��: !'tibbEtts En i .. o� g namingp- � � ,�„�,� Asa ° - CONSULTING ENGINEERS 716 Caiady Stree% TwurtoaMA M780 Tel. (508) 822.6934 F ax. (3M SM7311 FislddDensW T t R - Sand Cone AkLhod A STM W558 Client: Gatewood Homes Job No. 10980.010 1600 Falmouth Road, Suite 25 Date: 917/05 Centerville, MA 02632 Report No.: 2 Project: Mill Pond Village, West Yarmouth Ted Locaffon of Fiend Density Test FD5250A Lot M 33 - North Center - Boo of Footing - Sandy Greve; FD52505 lot #133 - South Cm* - Base of Fooft - Sandy Gravel FD525M Lot #134 - Nortin Ce3nler - Base of Footing - Sandy Gravel FD5250D Lot #134 - South Center - Base of Fo*g - Sandy Gravel FD5250E Lot #112 • Fast CmW - Base of Footing - $andy Gravel F05250F Lot #112 - West Carnet - Base of Footing - Sandy Gravel Tabyfa&n Flald Density Test Results Data Test No. Prack r I.D. Req. % obtained µsets Moisture Dry Wt Max Dry optirtim ConpL Compaction Specs. Ca wl P.C.F. Wt. PCF Maah" 9/712005 F05250A PR4252E 95 98.8 Yes 4.7 123.9 125.4 8.2 9/712005 ro52508 PR4252E 95 96.3 Yes 3.9 120.7 125.4 82 WOOS M5250C PR4252E 95 96.1 Yes 4.1 120.5 1254 62 917005 FD52500 PR4252E 95 95.7 Yes 42 1200. 125.4 8.2 9 M2005 FDS250E PR425M 95 99.6 Yes 3.9 124.8 125.4 8.2 9f7t2M FD5250F PR4252E 95 97.0 Yes 4.2 121.6 125A 5,2 Remarks: Test areas met the spedfied minimum compaction of 95%. Conec W for Oversize Particles In aocordance with ASTM D-4718. PAftUndes Walter P. GaWska Laboratory TecMiaan Laboratory Supervisor i of 1, TOWN OF YARMOUTH Building Department - _ Town Hall e Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-612 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 112 Owner's Name, Village @ Camp St., LLC Owner's Addres 1600 Falmouth Rd # 25 Centerville � MA 02632 Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 943 Net Owed: ($50.00) Application Date: 5/12/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.L: new construction: ZONING APPROVED 74e�. REVIEWED BY: Itelf. "WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: EALTH DEPARTMENT: DATE: N/A: 7BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: (— t-7 - L-L7 Date Printed: 5/24/2005 1 UNE & I WU I-AMILY ONLY - I311.11ILUIN(a FLIKM11 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING s Town of Yarmouth Building Department N 1146 Route 28 - Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 - Fax: (508)_398-0836 �t ffice[ise'Onty R a tea` Planning_oardi5forma#o�4+ AssessarstDpa�lxneJntf 1 x a4loyn �y��z3���p�,i k ax t L•, T 4 Y {h k J'^.i^ :i 9�w?V�, }.py3,!Lft� ��2'� i}.Ir) 9%}S Y. �'P.tF' �1 ly yY 13 S�aII �LO3.F .r ... W i }„ ermu-N �tG « td}if py' pY � Yy�c y q i �j pi_"i W"Y f IN Mt i t k W f -5air.S�r „' 'ii �Z iiJX }" S"Y h[`€ ''•t �y�• .�y"SYJT '+A��i 3 V1 � Y^q: ['1S �'T 5^�•➢S�L if 1' 3.. kM�Yk�;Y�!'itl� t yyLJw`���1 M�aAe'� L�dt1 t}�sF^� 2.}"f�''-"sis W4;c"'' ,4G'IIsWFe"I i..a 3 i��1}L .l..:: 'i°#^, " T�',Ca'T'Ya xP2e^tm9 �In ��R.:.. . 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Yv� 4Y .fd _.eebo>11, ,.MI.rat raTatta; Use Group: R-4 Type: 5- 1.1 Property Address: t 1.2 Zoning Information: Zoning District Proposed Use Lo 4Pti,;i, z 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 54) N FIoo�2©ne trifo yd�.�fyi g G`amer(rts znAw„r�r� n Public Private n �BFcn� «rtg,' a 5ECt1ACl;q,. `rt;0uv esfup_`F1vtarzdAge;` 2.1 \Ownekof Q Record". uc / 0V v N metprint`k Mailing Address CQL� V (Mi9 0:1- /U 1 V1 (" Signature Telephone�� 2.2 Authorizeq Agent: / A akro Name ( ) (` Mailing Address 63 Si ature a phone Fax i P I:' 1i 1:1 I III! I Z0 Seejot : carastruct,. ervace�= 3.1 Licensed Construction Supervisor. i- tAAi 1 G �� �� �� hpplicable ❑ _License Number l r,; _t (f" 3a' M i '_ O u✓'1� (3`j�f(� t l dd 7 S — 7 Expiration Date lD —A —C) Si nature Telephone if'+�^Y. ivp ,ry.y 1 N i t. d y^YY w1 2Re tstaed Nfi-0tTa�ro r>?en C7a r�ctoCr. Company Name 0 IVJUN2 4 200 Not Applicable License N ber t, Address BUILDIN _ By Expiration Date Signature Telephone I— 9- 15-99 1 of 2 OVER echo) R v csfKerW1Z0 r�per�satlt fits aricd #idav�f �t�IA c � 32,S.2�G�(fi �' ' , t►. Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial f the issuance of the building permit. Signed Affidavit Attached Yes ........:, No .......... S ctitn �"�escr{pftisir°����goser���!�io�k�c�ec'kall��"a(icat�ils} New Construction CRr I No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ I Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: l V� f cd V 1 Q ��:c�tcs�t`5��stiniatedCQistru�f-ton Costs-'. Item Estimated Cost (Dollars) to be Check Below completed by permit applicant Conservation-Comission Filing ❑ m 1: Building. 2. Electrical (H applicable) Q Old Kings Highway& Historical Commission approval (if applicable) 3. Plumbing / Gas 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Z 7. Total Square FL (new houses & addlions) /-5- � chor is i3wner''ALha a �T Awne'��1 efit�orn'�ractorFA 1ses�or be ompteted 11Vher BLtldrhgPe�trtrt I, `% e-C as owner of the subject property hereby authorize 16-e r to act on m beh , in all matters elative to work authorized by this building permit Application. Signature of Owner Date Sectio�JE7 ,'C3 +<merlAuttaonzed A en [)ectar�toori- as Qwner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print name / Signature of Owner/Agent Date �0Y 9-15-99 2 of 2 � � t X t jvwlv.vr YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE Location: PRINT I / t'1� `'' job Location: _ Mtn � S� .o .., Nur berg Street �^_ I Village Owner of Property: v J�1. LL• G Construction Supervisor: f cName �� �,� ( License No. Phone No. ° Address: / o i ��1/1�"` 1�m ,C"\:%LC d. lAn l Licensed Designee: (If other than Supervisor) ivame 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Anylicenseewho shall willfullyviolate subsections 2.15.1, 2.1-5.2 or 2.15.3 or anyother section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes . 2( No ❑ If you have checked M, please indicate the type coverage by checking the appropriate box.' A liability insurance policy [� Other type of indemnity ❑ Bond !61MG�e'rV'r S : I am aware that the licensee does not have the insurance coverage required .by Laws, and that my signature on this permit permit application waives this requirement. Cbeckone: of Owner or O*p&r's Agent Owner IM Agent Signature: Building Official Approval: P k cad"N The Commonwealth ofMassachusetts Department of Industrial Accidents OfAceo/l"esapiffess 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Ise 0 t0 1 am a homeowner pen orming all work myself. I am a sole proprietor =-J ha%e no one working in any capacity ❑ I am .an employer pro%iding workers* compensation for my employees working on this job. any na �ddress• - . city- N insurance ca. nnliry # 19-111 am a sole proprietor. general contractor• or homeowner (circle onel and have hired the contractors listed below ttho have the followina workers' compensation olices. cirr nhon # insurance co, nelin # company name: address- eauure to secure coverage as required under Section 25A of MGL 152 can lead to the in position of erindad penaltles o[ a one ap.to one yelrs' imprisonrtunt as well as civil penaltln iu the form of a STOP WORK ORDER and a fine of S100.00 it day against ma I a copy of this statement may be forwarded to the Office of Investigations of the DIA for, coverage verifieatloa. t do -hereby Print name of perjury that the information provided above is true and eo�em -, ❑a,� X ���ir5, �— K t�7/lg7?ems , official use oniv do not %rite in this area to be completed by dtv or town oRldal city or town: YARMODT$ rmiNieense # Pe nBuilding Department cheek if immediate rein ❑ response is required QUeensing Board ClSelettmen's Office 2ex �liealth Department contact person: (508) 398-2231 eat. phone q; _ nOther o�y``�[ TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTii MATTACH ES MASSACIiIJSETT$02664-4451 �•m.�••*�' Telephone (508) 398-2231, Exc 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at , Work Ad ess is to be disposed of at the following location: �_� (�✓►� DT %�� Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Date Permit No. r 1[f 00 - 35A00 cf, endosed,space (MGL C.Ti2 s.8oL) -- jA- Masopry oply I I G. -1.. &ZFamk.Homes Failure :topossess,a,aitrentedibon of the MassacFiosetts-State Buildhg.Code, .._# Is- cause f&rmocat;oriofmis-:ficense. DIG SAFE.CALL CENTER: {888) 344-7133 i 05/05/2005 14!09 508-7607L667 EASTERN-INS_YARMOUTH ' - "insurance IMATE OF LIABIUTY INSURANCE PRODUCERFAX 508-760-1667 THIS CERTIFICATE IS ISSUE ONLY AND CONFERS NO Rt( EasterLLC HOLDER THIS -CERTIFICATE 1, Atlantic Ave So Yarmouth MA 02664 INbuRED ape. Cod Custom Floors 762 Falmouth Ro d Hyannis MA 0260• PAGE 01 DATE (MMIDP'"") OS/OS/2005 OF INFORMATION r=RTIFIr ATF . . INSLFRERS-AFFORDINC -COVERAGE INsuRERA: Ar el a. Protection Ins Company ENSURER-e:' Raii'fOPt�' . .... . WSURER C NSURM D'--� MJf11OF0 F• � - COVERAGE NAMED ABOVE fOR THE POLICY PERIOD INDICATED: NO caTicrt na DIN THE POLICIES OFINSURANC LISTED BELOW HAVE BEEN ISSUED TO THE INSURED OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY -BE ANY REQUIREMENT. TERM 0 CONDITION OF ANY CONTRACTOR HEREIN ISSUB7ECTTO-ALL TPf6TERMS E=US10MS AND CONDtT10NS OF SLOW MAYPERTAIRTHEINSURAW SAFFORDED BY THE POLIOESOESCRtsED MAY HAVE BEENREDUCED.BYPAIDCLAIMS>_ POLICIES, AGGREGATEIIMIT .SHOWN FFECTIVE POLICY EXPIRATION LIMITS INSR )O' -. .TYPE OF 1NSUR UNSMY _ _ ._ . E ... POLiGY NUMBFA-... ...EM 7S000003Z3 12/13/2004 12113/2005 EACH OCCURRENCE. S- 1000 00 GENERAL LIABILITY - OAMAGE TO RENTEO f SO,Q )( COMMERCIALDENE _ LIABILFTY ... - MED E%r (Mry 4N_peRPn) -f _ ' S ,00 CLAIMS MADE OCCUR PERSONALA ADV INJURY S 1.00010 A GENERAL AGGREGATE- S 2. O00 OO PRDOUCTS - CDMPpP AGG f 2,000.0 O GENL AGGREGATELIMR POLIES PER- --I _ X POLICY APR LOC AUTOMOBILE LIABILITY .... COMBINED SINGLE LIMIT Me ecvden0 �. ANY AUTO _ ALL OWNED AUTOS . -. BODILY INNRV (varpenen) SCNEDULEO AUTOS _ HIRED AUTOS .. .. DOOL Y RLIIRY (Nf ettldenl) NON -OWNED AUTOS ... - PROPERTyDAMA%E S - ' (Per�ida4) - - AUt0.ONLY -EAACCWENT- S GARAGE LIABILITY EA ACC S' ANY AUTO _ OTMER THAN AUTO ONLY!- AGG. S EACH OCCURRENCE S'- 1 COB. EXCEEWMBRELLA W 4600029285 Y2/1312004- 12/I3/2005 AGGREGATE:. s- 1,000 00 X" occOR �] ILISWDE s' A s Fx DEDUCTIVE ' X T+c STATU .. OTH f.. RETENTION- S 10,00 .. OSWECKL11107- QS,L25/2 04 Q5725 [2005 El- EACN.ACCIDENT... S.-. 500 0O EMPLOYERY LIABILITY _OS/2S/2005_._W2S,L M. 9 IWORItERSICOMPENSMtONAN ANY PROPRIETORIPARTNERIV CIITIVF E.L:DISEASE-EAEIAPlOYE i' 50000 OFRCE"EMBER EXCLUDED? E.LDISEASE-PDOCYIIMR I... SQO.,. of s,de;wbcundM SPECIAL PROVISIONS bvfP OTHER . .. - DESCRWTIONOFOPERATIOMSILD TONS/VEHICLESIEXCLUSIONS ADDED BY EMDORSEMEMTI SPECIAL PROVISIONS dence of Insurance " Gatewood Homes 1600 Falmouth Al 025 Centerville, M -02632 ACORO2s(2D01MB) FAX: .(50B)779-S603-- - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPF AT10N➢ATEJNERFPOF, THE 15MI NO INSURER WILL ENDEAVOR TO MAIL ZT DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUJ- FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATIOHORLIABRIT)! OF ANY RINOUPORTHETNSURER.ITSAGETRS'OR"REPRESENTATIVES-- AUTHOR PRESENTATIVE /� li". . s - S t I (OACORD CORPORATION 1985 9Aecu0AalPCPn A ORM CERTIFICATE OF LIABILITY INSURANCE 1010410 °"""' PRCIDUCER Dowling & O'Neil Insurance Agency, Inc. 222 West Main St. PO Box 1990 Hyannis, MA 02601 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Assurance Construction, Inc A/0 Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURER A: Travelers Insurance Company INSURER B: INSURER C: INSURER D: INSURERS: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - IN5 LTR NSR TYPE OF INSURANCE POLICY NUMBER POPoLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR 16808387A9841ND04 08/01/04 - - 08/01/05 EACH OCCURRENCE $1,000,000 TO I RENTED DAMAGE PREMISES f30O OOO MED EXP (Any one person) $5 000 PERSONAL 6 ADV INJURY f1 O0O 000 GENERAL AGGREGATE f2 OOO OOO GENL AGGREGATE LIMIT APPLIES PER: POLICY PET LOC PRODUCTS-COMP/OP AGG $2,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMB (Ea accident) f BODILY INJURY (Per person) f BODILY INJURY (Per accident) f PROPERTY DAMAGE (Per accident) f i GARAGE LIABILITY ANY AUTO AUTO ONLY- EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGO f f EXCESSNMBRELLA LIABILITY OCCUR r CLAIMS MADE DEDUCTIBLE RETENTION f EACH OCCURRENCE f AGGREGATE f f f f WORKERS COMPENSATION AND EMPLOYERS' UAZILTTYART ANY PROPRIETOR/ EXCLNE UDRIEXECl7TNE OFFICER/MEMBER EXCLUDED? H yyes, describe under SPECIAL PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT - f E.L. DISEASE - EA EMPLOYEE f E.L. DISEASE -POLICY LIMB I S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. CAMCCI l ATIr m YLI\ I lrl VI.1 G 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Gatewood Homes, Inc. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN Attn. Paula - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1600 Falmouth Road, Suite 25 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Centerville, MA 02632 REPRESENTATIVES. AUTHORIZED REPRIESEkITATIVE %GIZ ACORD 25 (2001/OB) 1 Gf 2 #35866 1_51 W AGUKU \.VKrVKAI lvrs evoo 1� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DOWLING & 0 NEIL INS AGC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 222 WEST MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 1990 COMPANIES AFFORDING COVERAGE HYANNIS MA 02GO1 COMPANY 22LGR A ST. PAUL FIRE AND MARINE INSURANCE COMPANY INSURED - COMPANY / - HP BUISNESS SERVICES INC A 5su ancc l As1rvc B 118 WATERHOUSE RD COMPANY SUITE E ��jj����'' n� ��/�' C BOURNE MA 02532 ��CPlax Ii ti-LIv1UlA C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I co LTRI TYPE OF INSURANCE I POLICY NUMBER POLICY I DATE ME"MYY) FFECTIVE I DATE POLICY MM(DD1YV) "I LIMITS GENERAL LIABILITY i 1COMMERCIAL GENERAL LIABILITY CLAIMS MADE FJ OCCUR. OWNER'S & CONTRACTOR'S PROT. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 3E LIABILITY ANY AUTO is LIABILITY UMBRELLA FORM GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG. S PERSONAL & ADV. INJURY S EACH OCCURRENCE S FIRE DAMAGE (Any one fire) $ MED. EXPENSE (Any one person) $ COMBINED SINGLE $ LIMIT BODILY INJURY (Per Person) $ BODILY INJURY $ (Per Accident PROPERTY DAMAGE $ ALTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ONLY: EACKACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND STATUTORY LIMITS EMPLOYER'S LIABILITY (UB-4042B37-2-04) 12-24-04 12-24-05 EACH ACCIDENT $ 100,000 THE PROPRIETOR/ X INCL DISEASE —POLICY LIMIT $ -500 000 OFFICERS AREC�� II EXCL DISEASE -EACH EMPLOYEE S 100.000 COVERAGE RESTRICTED TO LEASED EMPLOYEES OF ASSURANCE EXCAVATION INC THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. AUTHORIZED REPRESENTATIVE Dates 5/5/2005 Tlmes 3302 PM TO: 19 15067785503 Paget 002-003 Client#- 24359 CAPECODREADY ACOR11n "Y" LI CERTIFICATE OF ABILITY INSURANCE , PRODUCER The Feiteiberg Compaq 222 Milliken Blvd. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE - THIS CERTIFICATE DOES NOTAMEW EXTEND OR - ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ALTER P.O. Box 3220 Fall River, MA 02722 INSURERS AFFORDING COVERAGE NAIC k INSURED INSURER As Acadia Insurance Companies Cape Cod Ready Mix Inc. INSURER B: Construction Industries Compensation PO Box 399 Orleans; MA 02653 INSURER C INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITI-ISTANOW, ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUE66R- MAY PERTAIN, THE WSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDrnONS OF SUCH POLICIES. AGGREGATE LIMIT'S SHOWN MAY HAVE BEEN REDUICEDBYPAID CLA MM, TYPE OF INSURANCE POUCYNUMBER LIE F E LYE AIMMIDIM POL XPIR D LIMITS A - GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a ^.' OCCUR CPA013246OW - _ 01/0'tffi&. 01hD1/06:. � EACH OCCURRENCE Si 000000 DAMAGE TO RENTED $100000 HIED EXP(Any "pawn) $5 000 -PERSONAL 6 ADV INJURY S11OOO 000 GENERALAGGREGATE 52000000 GEN'LAGGREGATE POLICY UMITAPPUES PER: PRO LOC PRODUCTS - COMPIOP AGG S2000 - A _ . AurOMOBILE LIABILITY ANY AUTO ALLCNJNEDAUTOS SCHEDULED ALITOS HIREDAUTOS NON-OWNEDAUTOS MAA013246910 01/011w, O1/OU06. _ - COMBINEDSLNGLEUMIT - (Eaac bro S1s�s00� ' BODILYINJURY Fe P` l S . . X X BODILY INJURY - g'sraCapsritl. S X 'PROPERTYDAMAGE �a aattlentl - GARAGE LIABILITY ANYAUTO _: _ - - - .AUTO ONLY • EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AM S S A - EXCESSAIMBRELLA LIABILITY _ X OCCUR Ej CLAIMS MADE OEDUCTIBLERETENTION $0 RA CUA013247010 01/Ot/05 01/01/06 EACH OCCURRENCE S1 OOOOOO AGGREGATE $ S S B WORKERS COMPENSATION AND EMPLOYEflX- L AIMITF - - ANYPRCPRIETOR/PARTNERIEXECUTNE OFFICEFVMEMBER EXCLUDED? e SPEOAL PROVISIONS helrnv WC0009255 - 01/01/05 01/01/06 X WC STATU- GTH• - EL, EACHACC30ENT $500000 F.L. DISEASE - FA EMPLOYE 5500 000 E.L. DISEASE POLICY LIMIT $500000-- OTHER DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES [EXCLUSIONS ADDED-BFENDORSEMENr7 SPA PROVISIONS ' Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Carterville-, MA 02632 LID ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF THBISSUING INSURER -WILL ENDEAVORTO MAIL 9( DAYS9rRRTEII - 5 TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL rzNOOBUCATIONOR-LIASTUTYOr-ANYKRDUPONTHEINMffWH tjSA"-NTSOR'- ACURa2512=108) 1 ot2 #SSOM/M66526 AHto-ACORD CORPORATION 1988 .05/06/2005 09:38 5084204474 EDWARD A GRAZLL ACORR - CERTIFICATE OF LIABIUTY. INS-URAAtCE.. � rppoucER THIS CERTIFICATE IS ISSUED AS A MATTER OF ��Fy��� ONLY AND.CONFERS NO RIGHTS UPON THE F [i A (�5aa11.Izt9lR't= I $ J T Ztc• HOLDER. THIS CERTIFICATE'DOES VOT AMEN) ALTER THE COVERAQEAFFORD£D :BY THE POI P:O. XX 337 Mar^trrs Mills, MA C2648 , ' -mSURESS_AFFORDING-COVERAGE INSURER A:. TAa�r-.,gltlii. i YJSUREA R' Ste[im Chains IrrsuR 145 CattiCtt Hoed= . _ ... INSWREpD• - . -- ... manu7[IS � MQ a� . , , . .. • '� INSURED E MAY PERT POLICIES. -'LO-ENETAL LIA—-Is 4 CONIAEAAL LIABILITY CWMS MADE MADE OCCUR ..._._.��M000939169 a. E ANY AUTO ALLOWNED AUTOS SCHEDULEDAUTOis mRED AUTOS NON -OWNED AUTOS GARAOELIABILITY ANY AUTO l Occw . - L I o(Am m0E -I DEDUCTIBLE RETENTION s R'onomm CDSIPENSATIONAND- EMPLOYERS- UADUM ANY PROPRA!TORrPARTNEIVEXECULVE OFIICERIMEMBEA EXCLUDED? IIYH tleFCAOA WON SPECIAL PAOY, SIONS belb.. OTHER OESCAIr110N Oi OPERATIONB /IOCAT10N5/yEHICLES7E11 CERTIFICATE L AEE JOW yTHOLLDDE.R TT__ C/o EaL.T'OAM mall - Rte -B -. GEntmvi ue, m C2632 Fpx... 1-508-778-5603 'HE INSURED NAMED ABOVE FOR THE POLICY PERIOD 'NE) CATED. THER DOCUMENT wrrH AEgPECTTO'WrBCH 7Hi9 CEflTIF1CA76:1 ago EREIN tS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CC IAID CLADS. . ►OLICY EFFECTVE DOUCYEYPIRA'AON LRa' EACH pt;,L1IRRENCE T I MEO ESF (Ag-eae Peat PAGE 02 NAIC i OF COMBMEDSINOLE LIMiT _ IEa aodA.all .. BODILY INJURY S -BODE'eneerN! Y I FRDPER7VDAeAZE - S (Pst.eddw+) _AUTOONLY-EAACCIDENT OTNERTHAN - EAACC S__ AUTO ONLY: AIGIG S EACHOCCURRGNCE t rTEAASVGAMEGV�} — s S TO rRrLWOA.T� FRL.:1 - E.L DtSEASE- ;/{NCELLATIUM' ENO" ANY OF THE ABO EDESCRIBIM EOLICIM Be CANCELLED BEFDRE.THE EK9INAT DATE TtfE1fEW: THE Bi URER V LL ENOEIVOR TO MAR.OATS TFROTEN NOTICE TO,TNE CERUMATE HOLDER NAMED TO THE LEFT. BUT FAXURE TO DO SO SHALL IMPOSE AW-CouGASION-00 UABILMY. OF. ANY. KIND UPON THE WSOAElt RSA6Efii8-0R REPRESENTATIVES. LUTNOIj W REFREEENTATwE .. �•-_ DATE 0 ACORD., CERTIFICATE OF LIABILITY INSURANCE /28 oo ' PRtOUt-ER- Serial # A1530 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ROBERT P. BIXBY, CPCU ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 830 -651 PUTNAM PIKE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. GREENVILLE, RI 02828 INSURERS AFFORDING COVERAGE NAIC# INSURED HOLMES AND MCGRATH, INC. 362 GIFFORD STREET INSURER A: NATL FIRE INSURANCE CO. OF HARTFORD USURER B: VALLEY FORGE INSURANCE CO. USURER C: CONTINENTAL CASUALTY CO. FALMOUTH, MA 02540 INSURER D. INSURER E . • COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAI M- ersrt A AODti TYPE OF INSURANCE GENERAL LIABILITY )( COMMERCIAL GENERAL LIABILITY CLAIMS MADE QX OCCUR POLICY NUMBER - - POLICY - 1074082434 EFFECTIVE DATE (MMMDnffl 10/06/04 Y EXPIRATION DATE 10/06/05 LIMITS EACH OCCURRENCE - $ 1,000 000 PRENIG SO occ�rence MEDExP o PERSONAL R AOV INJURY GENERAL AGGREGATE M2500,000 PRODUCTS - COMP/OP AGG GENL AGGREGATE UMITAPPUES PER: PRO- JECTLOC POLICY AUTOMOBILE LIABILITY �w SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per Perstxi) $ SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY $ WERTY GE s GARAGE LIABILITY AUTO OILY -EA ACCIDENT S ANYAUTO OTHER THAN EA ACC AUTO ONLY.. AGG $ S EXCESSNMBRELLA LIABILITY OCCUR F-1 CLAIMS MADE EACH OCCURRENCE $ AGGREGATE - $ S S DEDUCTIBLE S RETENTION 'S WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY 2057445273 09/01/04 09/01/05 X WC STMTU-117H- EL EACH ACCIDENT $ 1 000 000 B ANY PROPRIETORIPARTNER/DTCUTNE OFFICERMIEMBER EXCLUDED? I daori'N= S below SPECIAL PROVISION EL DISEASE - EA EMPLOYEES 1,000,000 ELDtSEASE-POUCYLIMIT S 1000000 C JOTHER PROFESSIONAL LIABILITY AEA 00 43133 38 07/13/04 07/13/05 $1,000,000 PER CLAIM! AGGREGATE DESCRIPTION OF OPERATIONS)LOCATIONS/VENICLESIEXG USIONS ADDED BY ENOORSEMERTISPEOULL PROVISIONS AGGREGATE LIMITS ARE PER THE TERMS AND CONDITIONS OF THE POLICIES. / CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION - - DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN GATEWOOD HOMES, INC. NOTICE To THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL - 1600 FALMOUTH RD., STE. 25 CENTERVILLE, MA OM32 IMPOSE No OBLIGATION OR LIABILITY OF ANY IUND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ALIT REPRE ^1 nn wwCM�wTInAt •004 ACORD 25 (2001/08) �..... , . _,_ .._.. C*.TWRO\CERTPROS.FP5 DATEIMMIDOM-M ACORD ,.C�ERTIFICAT.E.OE LIABILITY INSURANCE 5�4/05 , THISCERT!RCAmISISSUED ASAMATTER OFIkgMATION rz_;m R ONLY AND COI�RSNORIGHTS UPON - United Ina=ance Agency, Inc. Hmw'TMS-E��TEDOFS-NCRANENREXT8aOR- 199 Main Street ALTER THE COVERAGE AFFORDED EY THE POLICIES MOW. 7.O. Box 1013 Buzzards Bay, MA 02532 INSUREiSAFFOROItRGCOVEOAGE N41Cil INSURER A: zurich NA ... - INaDR Patton Electric, Inc. INLURERS: Liberty Mutual Ina. Co. 128 Scituate Road INSURERC: Mashpee, MA 02649 INSURER O: 'OVERAGES _ TTIEAOLICIES OF INSURANCEMOROONDBELUM ON OF ANY BEEN tSSV CONTRACT ORO ER DOCUMENT IWTN RESPECTTO WHIC".TNIS CERTIFICATISMAY gE ISSUED OR DIN ANY REOUIREMEENT, MAY- PERTMN-THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIo CLAIMS" - --EOUOriEFfECTt1E- 7000Y. __ .__. ALL LIMITS—-_ C"ERCIALOENFJTALLMBLITY SCp42415399 A _ CLAMS MADE OCCUR X 1PQUCT f I JEC__ _ 4.. `, tor_ AUTOIIOBLELNBILITY AWAUTO ALL ONMEOAUTOS SCHGDULMAUTOE H1REDAUTOS NON.owNEOAUTOS ..7/30/04 .. 7/30/OS ANYAUTO EXCES3NM BRELLA LUIBIUTY OCCUR CLAIMS MAOE DEDyCTOtE RETENTION S INORXaRS COMPENSiBiON AND B EMILOYEIa•UMU" WC23iS353049414 12✓1O/0A .. 12/.iD105 ANYPROPR IETOR)PIRTNERM(ECUTNE O��FsFFICERIMEMBER EXCLUDED" SPECIµ PRO 9N71SOebw X . OTHER BIDORBEMEHT DBTCRNTIDN of OF[ Electrical Gateway Homers, Inc. 1600 Ralnouth Rd., unit ;!5 fax 508-778-5603 Centerville, Ma 02632 7A1,TADfRTRtNNL •REAItSEStEsaacve�l ... - S 30a, 000- MEDEXP(Ae one RWII 3 10 000 PERSONALAAOV IN NRY S 1.,-OOD,,.O0.0._ GENERALApOREGATE $ 2,000.000 PRODUCTS•CDMPiDPAGG : •,_0_Q1L4Q� COMBINED 3MOLE LIMB S (Fad DOOLY INJURY S (Pa wb" BPT aLC.ltlu!)RY ' S.. . PROPERTY DAMAOE S (Pv mddaM AUTOONLY• EA ACCIDENT S EAAr'r' 3 OTHER THAN AUTDONLY. ACO S M1.I IRRENGE i S VC '--. EA EMPLOYEI POLICYUMIT SHOULD ANY of THE ADOVEDESCRIDED pMXXSBECAHCELLED BErO/�RE THE EXPIRATION ER JYATETHEOF. THEU:WINGINSVRER WILL IN/DEAVORTO MAL _lQ,._D/IYSWRRTEN NOT(CETO THECERTFICATE MOLDER NAMED TO TH E LEFT, BUT FAILURETOD0809RALt' IMIOSENO ODUOATNTN O VIABIUIYOr ANY KIND UPON TJIERILURPJLITSAOENTD OR .1 A017D 'CERTIFICATE OF:LIABILITY= -14 INSURANCE M °�'�`M�°°'' 3` 9 15/04� PRODUCER Chatfield, Whitman & Young 549 Washington Street THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 850963 COMPANIES AFFORDING COVERAGE Braintree, MA 02185-096 COMPANY A Harleysville Worcester ins Co INSURED r Lawrence Robinson Masonry COMPANY B 5 Fresh Hole Road Hyannis, MA 02601 COMPANY C ' COMPANY D 777777 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDNY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE aOCCUR OWNER'S a CONTRACTOR'S PROT - CB 7E 32 32 9/07/04 9/07/05 - GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG S 2,000,000 PERSONAL B ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 100,000 MED EXP (Any we person) $ 51 0 0 0 - AUTOMOBILE LIABILITY COMBINED SINGLE LIMB E ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per axident) $ NON -OWNED AUTOS PROPERTYDAMAGE $ GARAGE LIABILITY - AUTO ONLY -EA ACCIDENT $ ANY AUTO OTHLY: ER THAN A11T0 ON EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND - EACH OCCURRENCE S AGGREGATE $ VJC TATdU OTH- TORY LIMBS ER $ ' EL EACH ACCIDENT $ EMPLOYERS' LIABILITY EL DISEASE - POLICY LIMIT S THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL - - EL DISFJISE-F1. EMPLOYEE S OTHER DESCRIPTION OF OPERATIONS/LOCATONSNEHICLESISPECIAL ITEMS - CERTIFICATE -HOLDER $'CANCELLATION - - mew SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Gatewood Homes EXPIRATION DATE THEREOF, THE ISSUING COMPANY WALL ENDEAVOR TO MAIL 1600 Falmouth Road 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Suite 25 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILI Centerville, MA 02632 OF ANY KIND UPON THE COMPANY EN SENTA S. AUTHORIZED REPRESENTATIVE Robert E. Chatfield ... AC`ORD 25S (1l95j. u - OACORD GOktro—N�vi , ACORD. CERTIFICATE OF LIABILITY INSURANCE. Ro 6 09-27-2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PAYCHEX AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 210706 P: (877)287-1312 F: (877)287-1315 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 308 FARMINGTON AVE INSURERS AFFORDING COVERAGE FARMINGTON CT 06032 INSURED wsURERA:Twin City Fire Ins Co INSURER B- LAWRENCE ROBINSON MASONRY INC INSURER C: 5 FRESH HOLE ROAD INSURER D: HYANNIS MA 02601 INSURER E: �Wvcnrow THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WSR T TYPE OF INSURANCE POLICYNUMBER POLICYEFFECTIVE DA TF IMMIDDIM POLMYEXPIRATION DATE MM O LIMITS GENERAL U4BRJTY EACH OCCURRENCE E FIRE DAMAGE (Any one fuel E COMMERCIAL GENERAL LIABILITY MED EXP (Any one pawn) $ CLAIMS MADE FIOCCUR PERSONAL& ADV INJURY $ • GENERAL AGGREGATE 8 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG E PR0. LOC POUCY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per Person) 3 ALL OWNED AUTOS _ - SCHEDULED AUTOS BODILY INJURY (Pa accident) HIRED AUTOS - - - - - - - NON -OWNED AUTOS PROPERTY DAMAGE (Pa accident) $ GARAGE LL488JTY AUTO ONLY - EA ACCIDENT E OTHER THAN EA ACC E ANY AUTO E AUTO ONLY: AGG EXCESS LIABILITY - EACH OCCURRENCE E AGGREGATE - E OCCUR 0 CLAIMS MADE E $ DEDUCTIBLE - E RETENTION 3 - WORXFRS COMPENSATION AND WC STATU- OTH- X TOR E.L. EACH ACCIDENT $100 000 A EMPLOYERS'L/48AJrY 76 WEG NQ5620 09/06/04 09/06/05 E.L. DISEASE - EA EMPLOYEE $10 0 , 0 0 0 ' E.L. DISEASE -POUCY LIMIT $500 000 • OTNER DESCRPTLON OF OPERA7I0NS20GA TIONSNEMCLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECNL PROVWONS Those usual to the Insured's Operations. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO GATEWOOD HOMES OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1600 FALMOUTH ROAD, SUITE 25 REPRESENTATIVES. CENTREVILLE MA 02632 A�LMRRED REPRESENTA ACORD 25-S (7197) 1Z/02/04 13:36 FAX 5087900249 GOLDMAN ASSOC IM02 ACbgD' 'CI=RTIFICATE OF LIA LUTYINSttR/�I�tCE CSR AW - -- TAVAN50 "-"` 12 02 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GOLDMAN & ASSOCIATES INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FINANCIAL SmtVICBS INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 933 FALMOUTH RD. ALTER THE COVERAGE AFFORDED -BY THE POLICIES BELOW. HYANNIS MA 021601 Phonal SOB-715-6610 FaxeS08-790-0249 INSURERS AFFORDING COVERAGE NAIC9 INSURED wsuRERA: MARYLAND CASUALTY COMPANY INSURER S: RODNP:T TAVANO DBA PIRCHANICAL SYSTEMS INSURER C: INSURER a W1BAFNSTABLSNSNA 02668 INSURER E THE POLICIES OF INSUUNCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REODRG/IENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RE6PECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR - MAY PERTAIN; THE INSJRANOE AFFORDED BY THE POLICIES DESGR*W HEREIN IS SVWECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAM CLAIMS LTR NSR TYPE OFINSUR.ANCE POLICY NUMBER DATE AMID DA E EXP _R^TQN LIMITS - A GENERALLUEEJTY Y COMMERCIAL GENERAL LIABIUTY CUM MADE ❑ OCCUR 000372088 _ 11/21/04 11/21/05 _ EACH OCCURRENCE f 1000000 PREMISES (Ea emrenrw) s300000 MM I"(AM one pelewl) f 10000 PERSONAL &ADV INJURY $1000000 GENERAL AGGREGATE S 2000000 GEN7. AGGREGATE LVAT APPLIES PER: POLICY ! SEPTF-ILoc PRODUCTS -COMPlOP AGO s 2000000 . AUTOM10S IX LIABILITY ANY AUTO ALLOWNF9AUTOS smIEDuLmAuTGS FIRED AUTOS NO"'A'N€D AUTOS - COMBINED SINGLE LA" (Ea secdent) .. s BODILY INJURY (Pwpn ) - s BODILY s1JURY (Perersleenl) f PROPERTY DAMAGE (ParatXtcenq f DAgAS7E LWNUIY ANYAUTD AUTO ONLY -EA ACCIDENT f— OTHER THAN CAACC AUTO ONLY: AGO S S EXCESSRI®RUJ A UAINUTY OCCUR CLAIMS MADE DEDUCTIBLE -__ RETENTION.t_ S_ EACH OCCURRENCE f AGGREGATE S S • WORKERS CO PEIMATION AND --EMPIDYERb' LIABIJEY ANY ERIMEETORAIARTNDED? CUTNE OFFICEFUMEABER bICIUOFAT �tl CNrnLe=1 �rI.I pp0VL5piyq ydR,n TORY IWfB ER F.L. EACH ACCIDENT s E.L DISEASE -EA EMPLOYEE f El. DISEASE -POLICY LIMiT S OTHER DESCRIPTION OF OPKMr=S I LOCJATICNS/ VEH. LL$ I CXCL-wJ�-OMCRRC'Yt>1CNJ-- - name &AT urH RICO cYNCELLATII]N I _aTT[WtTA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEiLED BEFORE THE EXPIRATION ----- -- DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYSWROTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. MR FAILURE TO DO 30 SMALL GATZ91GOD'-HORIES INC`'.: FAx 508-778-5603 1600 FALMODTH ROAD SUITE 25 . IMPOSE NO OBLIGATION OR LIABILITY OF ANY IUND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AIJTHO REPRESEATIVENT CxNT19RVnAX HA 02632 ACORD 2S (2001108) ViI RA.YRY 4URr'YrV�INR logo', nl$II 4I'6X naZ 6ZVLU J/.mil GVVU 1V:J.7 YAVL. VVY/VVY P6X DCL-VCZ- F, a s a ( /1��V�i��• , C�i�f��lE�4T� ���! u L x � f� DATE.CMMWBtTYJ' 1/'Y[t�� " 2 i-., y " PRODUCER THIS CERTIFICATE IS ISSUED QS Q MATTER OF INFORMQTt9N ` GOLDMAN ASSOC IIZs FIN -�'�-AND-EONFER�S-MO-RIGHTS- UPOP1-THE--CERTiRCAa'E-- HOLDER. 933 FALMOUTH RD RTE 29, THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THECOVERAN;EAFFORDEDBYTHE 20UC1E LSgFI nw HYANNIS MA 026012319 .... COMPANIES AFFORDING COVERAGE - 29HPP COMPANY - - A—-AMERICAN'2URICH'rNSURANCE-COMPAWT- INSURED TAVANO, RODNEY DBA COMPANY MECHANICAL SYSTEMS B 201 CAPES TRAIL COMPANY WESr'BARNSTABLE MA 02668 C`... COMPANY D THAT THE POLICIES OF INSURANCE THIS !SED, NOTIFY s w.� Y LISTED BEJAVU HAVE BEEN ISSUED TO THE INSURED NAId�ED�ABWE-FOR INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDI110N ' CERTIFICATE -.MAY BE E:SUED_ OR_MAY PFRIAW, THE THE POLICYPERtOD-- OF ANYUMENT WITH -INSURANCE. AFFORDED BILTHECOPOL(ACtESD,ESCRIBEDOHEREW IS EXCLUSIONSANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SUBJECT ip-pLLTHECHH THAS�...- LT TYPEOFINSURANCE LTR pOLNOy�B� - POLICY EFFECTIVE _ POLICY EXPIRATION _ DATE TM111L4D")"" DATE(M&TcMyy)- - ..LIMITS - GENERAL LIABILITY - COMMERCIAL GENERAL LIABILITY GENERAL ACGREW. E s - x:. CLAIMS MADE aOCCUR PRODUCTS-COMP/OP AGG. s OWNERS A CONTRACTORS PROT. - PERSONAL S ADV. INJURY $ ... CH OCCURRENCE- ' - $ - . FIRE DAMAGE (Any oie fire) $ AUTOMOBILE LIABILITY ED. EXPENSE(AFy One Person) e ANY -AUTO '- - - COMBINED SINGLE ALLOWNEDAUTOS LIMN -. . SCHEOULEDAUTOS- - BODILY INJURY HIRED AUTOS (Per Pefs2n)- S. NQN-OWNEDAUTOE_ _ BODILY INJURY . - (Per Accideni) .... $ GARAGE}IABILIT' PROPERTY DAMAGE 5... ANYAU70 - AUTO ONLY -FA ACCDENT , OTHER THAN AUTO ONLY: ' .. EACH ACCIDENT 6 EXCESS LIABILITY - - AGGREGATE 3 UMBRELLA FORM .. EACH OCCURRENCE s OTHER THAN UMBRELLA FORM AGGREGATE S A WORKERS COMPENSATION AND --, EMPLOYF3'SLIABNLITy (UB-727BA89-9-05). a, 05-03-05 05-03-06 STATUTORYUfNsTHEP- - PARTN PflIETCU PARTNERS/EXECU'DVE INCL :;. EACH ACCIDENT � 10D 000 OFFICERS ARE 'X- EXCL - DISEASE-POLJCY CIMIT $ 500 000 ER_ - .. DISEASE-EACH�EMPLOYEE OESCRIPTIONO OPERAONSNEHI LES'RE TRICAONS'SPECIAL.ITEMS . THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. RTiFTCATE HOl[)Ef W GANCFEkitOt _ __ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES - BE CANCELLED BEFORE THE`, EXPIRATION DATE THEREOF, THE ISSUING - COMPANY WILL ENDEAVOR GATEWOOD HOMES INC TO MAIL -10 DAYS- ' " WRITTEN NOTLCET07HECERRF=TE'HO[DERNAMEDTOTME- 1600 FALMOUTH RD SUITE 25 LEFT BUT. FAILURE_TQ MAIL SUCK SMALL CENTERVILLE- MA 02632 -NOTICE. IMPOSE N0. OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTAnvm AUTHORIZED REPRESENJA� TI1fE. ! i 011 SCALE: o o�QA i sF�R / \ LOT111�Rq� rye. 0 LOT 109 L 112 72.nu ,L ssi*47�1 GRAPHIC SCALE ( IN FEET) 1 inch = 20 ft PLOT PLAN OF LOT 112 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA- 1"=20r DATE: 1-5-05 y0p0S V SRN FF� ?3 ?• . cly ?S le FAR e�� Mq�N l 2S. 959, ply . J I� sFR�ce k/• ro PROPOS Hp(JSE I1 N cp•� yfRpN FF a S NOTE: SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. 0 NOTICE Unless end until sach time as the original (red) stamp cf the responzit!e Professional Engineer, or Professional Land Sur; t::r app<_ora on this pion: (A) no perscn or persons, including any municipal or other publlc officials, may rely upon the information cantoined herein; ar.1 (B) this pion remains the property of H'Ames A M meth, Inc. holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2536 CHECKED:-7,* 07 - TIA^.OTHY M. - o SANTOS No. 4se7d -clvl� 5), O� �� CF � C/3TEVI'- <:' PROPERTY ADDRESS: .-ALCULATION FOR P_ER1Y�{T COS7 3 0', 90 AD !LTERATIONS I 32Z Ss, BA BEI bid, 7� CEI Ca gI? DE4 nEc T TE OF ROOM G YS TOWN OF YARMOUTH (64 Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-612 Applicant Name: Frank Capra (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 943 Net Owed: ($50.00) Application Date: 5/12/2005 Issue Date: Expiration Date Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 112 Owner's Name: Village a Camp St., LLC Owner's Addres 1600 Falmouth Rd # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: Comments: Map/Lot: 044.21.1.0 new construction, DATE: DATE: p[a@T0MF-9D N/A: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: ,, 7 DATE: �j�/3 Q� N/A: 5. BUILDING DEPARTMENT DATE: N/A: 6. FIRE DEPARTMENT: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: N/A: DATE: Date Printed: 5/24/2005 TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : May 31, 2005 Letter of Water Availability 1. Single Family Dwelling X 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial 5. Other (Specify) / Industrial Reference; Massachusetts General Laws Chapter 40, Section 54 To : Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth Public water supply is available to service lot/parcel(s) 21.1 as shown on Assessors sheet/map # 44 Street 121 Camp St., #112 Issuance of this Letter of Availability is subject to the following provisions/restrictions. (1) The property owner agrees to comply with all Federal, State, and Local Laws, Rules and Regulations as they pertain to the use of the Public water Supply. (2) The Yarmouth Water Department shall have exclusive rights as to the size, number, type and location of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owners expense, the installation of water mains and appurtenant items to meet water demand requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue. I have read and understand the provisions/restrictions of this Letter of Water Availability. �Rdn& �^ / ►, Reference Owner (Sign) : Villages ® Camp St., LLC : 1600 Falmouth Rd., #25 : Centerville, MA 02632 Yarmouth Wat r epartment TOWN OF YARMOUTH Building Department dimTown Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-612 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 112 Owner's Name: Village @ Camp St., LLC Owner's Addres 1600 Falmouth Rd # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 943 Net Owed: ($50.00) Application Date: 5/12/2005 Issue Date: Expiration Date comments: Map/Lot: 044.21.1.0 new construction: REVIEWED BY: -✓1: WATER DEPARTMENT: - DATE: �/ ,]� N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: DATE: DATE: DATE: N/A: N/A: N/A: N/A: DATE: Date Printed: 5/24/2005 MYUd3Zt$ MPD3530 - MPD4035 33' fireplace w/opt. flusb face 3S' fireplace w/brusbed stainless 40' fireplace w/polished brass louver and door trim trim arch door kit Beauty, efficiency, convenience and reliability. Just some of what you'11 find in our Lennox Merit® Plus Series direct -vent gas fireplaces. Our combo DV configuration, with both top and rear outlets, allows for top or rear venting (except our 33" units which have either atop or rear outlet). Standard features include a deluxe pan burner that produces big yellow flames and glowing embers, brickaded interiors and Hi/Lo flame opera- tion. And, these models are even easier to warm to when you select one of our optional remote controls, or Tl1IlC�G� ��n nn �n t�w.•nl. n.t ..� �t � __. _ MPD4540 MPD4035 MPD3530 MPD3328 Stad Features rd. DIMENSIONS (Rear vent model shown) • Louvered face design • Charred split oak gas log set • Deluxe pan burner for big yellow flames and glowing embers • Charcoal black exterior powder coat finish • Realistic brickaded interior panels • Combo top/rear direct -vent outlets (except 3328 models, which have either a top or rear outlet) • Hi/Lo flame operation • Pre -wired for wall switch • Choice of standing pilot (works in a ower failure) or pilotless electronic intermittent) ignition • Decorative polished brass or brushed stainless accessories (arch door kit, door trim, louvers, hood) • Wireless remote controls • Blower kits (including a temperature control version) • Screen panel kit (heat guard) • Radiant panel kits (for a clean face look) is Series direct -vent gas fire laces utilize either (rigid) or Secure Flex lflentble) 4.5' ter coaxial venting system, and include a d warranty. e to Lennox' ongoing commitment to quality, >ns, ratings and dimensions are subject to at notice. ditions, such as elevation, wind vent configu- oice of fuel will affect the overall appearance Hersey 020006711) WemoekHem" W C US The first two model number digits indicate frame width, the last two digits indicate glass width. All are AF.U.E: rated high efficiency vented gas fireplace heaters, certified under ANSI Z21.88 and CSA 2.33-M99. 3328 MODELS (This model comes as a top or rear vent only) r� H c e D 1 lane„ _ 1-1rr 4-1rr' Front Face 35,40 & 45 MODELS Right Side Top (These models come with a top and rear vent) Front Face Top Right Side FIREPLACE & FRAMING DIMENSIONS 3530 351/8 321/8 19 29't 351/8 2111h6 247/8 12%6 351/4 351/4 16 4035 401A 374 24 341h 401/8 2611h6 297/s 141Sh6 .40t/4 40i4 16 45C 401A 371/8 24 391/t 451/8 261 A6 34%8 17%i6 451/4 401/4 16 t. m� 332BT NG 17,500 45 64 62 332BT LP 17,500 49 66 64 3328R NG 17,500 53 63 61 3328R LP 17,500 55 66 64 3530 NG 20,000 S3 64 62. 3530 LP 20,000 55 62 60 4035. NG 27,000 59 69 67 4035 LP 27,000 60 69 - 67 4540 NG 29,000 59 69 67 4540 LP 29,000 59 69 67 'Intermittent ignition systems Canada I Look for the EnerGulde r.. n...a.... F .e..,.. - TYPICAL ROOM APPLICATIONS viceneu LM • (✓M1%J+oho-3 F& UCT SPECIFICATIONS GMS 9/GCS 9 SERIES 93% AFUE Multi -Position, Single-Stage/Multi-Speed Gas Furnace Heating Capacity: 46,000-115,000 BTUH yP Iff S LIMI FED -WARRANTY. SO GPAIM aeta Etk Inkmum Em � Standard Features • Corrosion -resistant, aluminized -steel tubular heat exchanger and stainless -steel recuperative coil for maximum efficiency • Designed for multi -position installation--GMS9: upflow, horizontal right or left; GCS9: downflow, horizontal right or left • Energy -saving, reliable Hot Surface Ignition system, featuring a Norton® Mini -Igniter with patented adaptive leaming algorithm to maximize igniter life • Aluminized -steel inshot burners • Energy -saving PSC, multi -speed, direct drive blower motor • Quiet, corrosion -resistant induced draft blower assembly • Integrated furnace control with improved diagnostics • Low voltage terminal blocks • Multiple flame roll -out switches, blower door safety switch, outlet air -limit switch and pressure switch for proof of combustion air • 40VA transformer for heating and air conditioning control service • Combination redundant gas valve and regulator • Top venting is standard; alternate flue/vent located on right side • Completely assembled, factory run -tested furnace for heating or combination heating/cooling application • All models comply with California NOx Standards • Suitable for direct vent (2-pipe) or non -direct vent (I -pipe) applications 0I0I.11010 Air Conditioning & Heating The GMS9/GCS9 single -stage, multi -speed gas furnaces offer installation versatility. Cabinet Construction • Heavy -gauge, reinforced, fully insulated steel cabinet with durable baked -enamel finish • Attractive architectural gray paint finish • Foil -face insulation -lined heat exchanger compartment • Coil and furnace fit flush for easy installation • Convenient left or right connection for gas and electric service • Bottom or side air inlet (GMS9) • Removable, solid -bottom block -off (GMS9) Accessories • L.P. Conversion Kit (LPT 00A) • L.P. Gas Low Pressure Kit (LPLP01) • High Altitude Natural Gas/L.E Kits (HANG11, HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFR01) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit—upflow, horizontal (RF000180) • Internal Filter Retention Kit—downflow (RF000181) • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H2OTWR) SS377D w ..goodmanmfgxom 6774 i I I MAScheck COMPLIANCE REPORT Massachusetts Energy Code I Permit # MAScheck software version 2.01 Release 2 I I I I Checked by/Date CITY: Yarmouth STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 5-7-2004 DATE OF PLANS: 05/07/04 TITLE: The Tern PROJECT INFORMATION: Tt�v Mill Pond village Camp Street Yarmouth, MA. f� COMPANY INFORMATION: Northside Design ASSOC. 141 Main Street y ,t Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 354 Your Home = 190 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-value U-Value UA ----------------------------------------------------------------------7-------- CEILINGS 1030 30.0 30.0 18 WALLS: Wood Frame, 16" O.C. 2043 15.0 15.0 90 GLAZING: Windows or Doors 115 0.340 39 GLAZING: Windows or Doors 40 0.340 14 DOORS 40 0.086 3 FLOORS: over Unconditioned Space 1030 19.0 19.0 26 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and 34.4. Builder/Designer Date I ) • ,, l , . Massachusetts Energy Code MAScheck software version 2.01 Release 2 The Tern DATE: 5-7-2004 Bldg.l Dept.l Use I CEILINGS:, C l I 1. R-30 + R-30 I Comments/Location WALLS: [ ] I 1. wood Frame, 16" O.C., R-15 + R-15 Comments/Location WINDOWS AND GLASS DOORS: C ] I 1. u-value: 0.34 I For windows without labeled u-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location [ ] I 2. u-value: 0.34 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location DOORS: C ] I 1. U-value: 0.086 I Comments/Location FLOORS: [ ] I I. Over Unconditioned Space, R-19 I comments/Location I AIR LEAKAGE: [ ] I joints, penetrations, and all other such openings in the building envelope that are sources.of air leakage must be sealed. when I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type is rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type iC rated, in accordance with standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled.. VAPOR RETARDER: C ] I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. i MATERIALS IDENTIFICATION: C ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating 1b • I I I I I E] I and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: Ducts shall be insulated per Table 34.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HvAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): HEATING SYSTEMS: .Low pressure/temp LOW temperature Steam condensate COOLING SYSTEMS: chilled water or refrigerant PIPE SIZES (in.) TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" 201-250 1.0 1.5 1.5 2.0 120-200 0.5 1.0 1.0 1.5 any 1.0 1.0 1.5 2.0 40-55 0.5 0.5 0.75 1.0 below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.): HEATED WATER TEMP (F): 170-180 140-160 100-130 PIPE NON -CIRCULATING RUNOUTS 0-1" 0.5 I 0.5 I 0.5 I SIZES (in.) CIRCULATING MAINS & RUNOUTS 0-1.25" 1.5-2.0" 2.0+" 1.0 1.5 2.0 0.5 1.0 1.5 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)----------- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (OFFICE SE ONLY) TOWN OF YARMOUTH By - Fee: $ .E�z (PLEASE PRINT IN INK OR PE ALL I) To the Inspector of Wires: By this applicat: work described below. Location (Street 8� Nu Owner or Tenant -,) PERMIT NO. oz v ITION) Date: c? ndersigned gives notice of his or her intention to perform the electrical ,TPI Owner's Address I `e` " T Is this permit in conj tion with a building permit? Yes Q No (Check Appropriate Box) Purpose of Building 1X_U1r r Utility Authorization No. Existing Service Amps / Volts Overhead New Service % Number of Feeders and Location and Nature of Proposed electrical OverheadQ No. Undgrd C] No. of Meters Undgrd @--�No. of Meters rnhl..nnv he wn;vad by the Inmectorof Wires d No. o Total No- of Recessed Fixtures No. of Cei -Sus . Paddle Fans i Transformers KVA No. of Lightin-e Outlets No. of Hot Tubs n- Generators KVA No. of Emergency Lighung No. of Lighting Fixtures A00VC Swimmin Pool gmd. ❑ gmd. ❑ Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones o. o etectron an No. of Switches No. of Gas Burners Initiating_Devices No. of Ranges Total No, of Air Cond. Tons No. of Alerting Devices Heat Pump I Num r ons _ No. of Self -Contained No. of Waste Disposers Totals: — — — Detection/Alerting Devices Municipal Local ❑ Other No. of Dishwashers Space/Area Heating KW Connection Secutity Systems: No. of Dryers Heating Appliances KW No. of Devices or Equipvalent No. of Water KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent Heaters Telecommunications Wiring: No. Hydromassage Bathtubs No.of Motors Total HP No. of Devices or uivalent 'r d b the In ector of Wires Attach additional detail q sired, or as requt e y p INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to permit issuing office. Kul CHECK ONE: INSURANCE BOND OTHER0 (Specify:) �? (Expiration Date) lec 'cal Work: (When required by municipal policy.) Estimated Value off. to Start: ID Ins ctions to be re ueste to� accordance with MEC Rule 10, and upon completion. I certify, unde the s&andsury, tlaq inf Brio on this application is true and complete NAM LIC. NO. ensee: v.>\Signature LIC. NO. (If applicabl "exe er line.) Bus. Tel. No.: Address X Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Li nsee d s not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one owner owner's agent. ❑ wner/Agent 99 Signature Telephone No. :. 'CERTIFICATE OF INSURANCE0-5/06/2005 ISSUE DATE PRODUCER Harold H Williams Ins Agcy Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 81 Bassett Lane POLICIES BELOW. Hyannis, MA 02601 COMPANIES AFFORDING COVERAGE INSURED Stephen M Childs 145 Cammett Road COMPANY A.I.M. Mutual Insurance Co LETTER A Marstons Mills, MA 02648 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY) POLICY EXPIRATIO DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERALAGGREGATE S PRODUCTS-COMP/OP AGG. S COMMERCIAL GENERAL LIABILITY LAIMS MADEE::�iDCCUR PERSONAL&ADV. INJURY S EACH OCCURRENCE $ OWNER'S& CONTRACTOR'S PROT. FIRE DAMAGE (Anyone lire) $ MED. EXPENSE (Any om person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT S BODILY INJURY (Per p� n) - $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per =ident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE S GARAGE LIABILITY !EXCESS LIABILITY EACH OCCURRENCE S AGGREGATE $ I MBRELLA FORM j11HCR 1 THAN UMBRELLA FORM 1'ORRER'S COMPENSATION AND X A UTHLA A • IPLOYERS' LIABILITY HE PROPRIETOR/ INCL 7015793012004 12/13/2004 12/13/2005 EL EACH ACCIDENT - $ 100,000 EL DISEASE —POLICY LIMIT S 500,000 ARTNERS/EXECUTIVE FFICERS ARE: X EXCL EL DISEASE —EACH EMPLOYEE S ]QO 000 OTHER mscitirrION OI' 01'IiltA1'IONS/LOCATIONS/VEIHCLES/SPECIAL ITEMS - CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GateW00(1 Homes. - EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE - LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Bell Tower Mall Rte 8 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Centerville, MA 02632 RE -INSPECTIONS 1 S'. RE -INSPECTION - $20.00 2m RE -INSPECTION - $30.00 3RD RE -INSPECTION - $40.00 ALL OTHER RE -INSPECTIONS - $40.00 DATE: - 7 DATE RECALL: ISSUED REASON FOR RE- lt II pew OCCUPANCY PERMIT: PLUMBING PERMIT: GAS: ELECTRICAL: FIRE DEPARTMENT: -6 5-I Z